plexus injury. Few studies report the rate of revision surgeries following free functional muscle transfers. We examinedthe reoperation rate and indication for reoperation after primary reconstruction of upper extremity function with a freegracilis transfer after brachial plexus injury.Methods: From 2003-2016, we identified 25 patients who underwent a free functional gracilis ...

INTRODUCTION: Free functioning muscle transfers (FFMTs), nerve grafting and nerve transfers have led to improved functional outcomes in brachial plexus injury (BPI) patients. Reports have shown that 39% of FFMTs and 26% of nerve transfers for elbow flexion achieve ≥ M4 elbow flexion strength.1 However, there remains a substantial number of patients with less favorable functional outcomes that n...

INTRODUCTION: Free functioning muscle transfers (FFMTs), nerve grafting and nerve transfers have led to improved functional outcomes in brachial plexus injury (BPI) patients. Reports have shown that 39% of FFMTs and 26% of nerve transfers for elbow flexion achieve ≥ M4 elbow flexion strength.1 However, there remains a substantial number of patients with less favorable functional outcomes that n...

Introduction Traumatic total brachial plexus injury (TTBPI) is a severe and disabling form of injury. Reconstructive modalities are complex and outcomes are variable. This is mainly because of the multitude of functions lost and relative scarcity of donor nerves to reconstruct these functions. As a result, there are several different opinions and ideologies on TTBPI. Several papers report the f...

With the available microsurgical techniques, salvage of the limb can almost always provide a useful upper limb, even in the most complex combined injuries. Having a low threshold for revascularization of doubtfully viable extremities and making full use of the current armamentarium of soft tissue cover techniques, including flow through free flaps, will salvage many limbs. Secondary procedures,...

BACKGROUND After complete five-level root brachial plexus injury, free functional muscle transfer and intercostal nerve transfer to the musculocutaneous nerve are two potential reconstructive options for elbow flexion. The aim of this study was to determine the outcomes of free functional muscle transfer versus intercostal nerve-to-musculocutaneous nerve transfers with respect to strength. ME...

Brachial plexus and peripheral nerve injuries lead to significant upper extremity dysfunction and disability. Traditionally, both have been treated with nerve grafting when a tensionless, end-to-end repair is not feasible. Despite our best efforts, functional outcomes of this procedure are less than ideal due to the long distances that the axons must regenerate to reach their end organs. Over t...

Soft-tissue reconstruction following preoperative radiotherapy and wide resection of soft tissue sarcoma remains a challenge. Pedicled and free tissue transfers are an essential part of limb sparing surgery. We report 22 cases of sarcoma treated with radiotherapy and wide excision followed by one-stage innervated free or pedicled musculocutaneous flap transfers. The resection involved the upper...

The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional ...

IMPORTANCE Free muscle transfer innervated by a cross-facial nerve graft represents the criterion standard for smile reconstruction in facial paralysis. If primary reconstruction fails, a second muscle transfer is usually needed. Herein, we investigated the possibility of avoiding a second free muscle transfer by in situ coaptation of the gracilis muscle to the masseteric nerve. OBSERVATIONS ...